Athlete's Foot

Athletes foot or Tinea pedis, as it is called, is one of the most common problems seen by podiatrists. Some studies have shown that as much as 25% of the population is infected at any given time. The condition is much more common in men than women. The fungus can also get into the toenails causing a condition called Onychomycosis.

What are the symptoms of athlete’s foot?

  • Scaly skin
  • Burning feet
  • Peeling skin
  • Redness between the toes or on the sides of the feet
  • Painful cracks in the skin

There are a handful of different fungal strains that can cause athlete’s foot, but they all present in one of two ways.

  • Wet fungus between the toes
    • Fungus is moist
    • Tends to be worse between the 4th and 5th toes
    • Can be associated with very painful “cracks” in the skin called fissures
    • May have a strong odor
    • The skin may turn white in the affected areas between the toes
  • Dry fungus on the soles and sides of the feet
    • Fungus is dry and scaly
    • Found more on the outsides of the foot
    • Can also be associated with painful “cracks” in the skin called fissures

How is athlete’s foot diagnosed?

Diagnosis is usually made simply by clinical presentation. However, there are many other skin conditions that present quite similar to Athlete’s foot including: contact dermatitis, dyshidrotic eczema, dry skin, and psoriasis. If there is any uncertainty, your podiatrist may perform a KOH Test (potassium hydroxide test). The test is performed by taking a small sample of skin from the affected area on the foot and examining it under a microscope to look for the fungal elements. Other diagnostic testing that may be done include a PAS (Periodic acid-Schiff) stain test and DTM (Dermatophyte Test Medium) test.

How did I catch it?

Who knows? You can pick it up anywhere because the fungus is everywhere! The fungal spores are ubiquitous and found in most indoor and outdoor dust. It’s in your carpet, your clothes, your shoes, your bed… EVERYWHERE!!! It is important to note that becoming infected with athlete’s foot has little to do with hygiene. It doesn’t matter how often you wash your feet, infection is more determined by genetic predisposition. Some people are susceptible to it and some are not. It is not uncommon to see a husband and wife situation where the husband has been battling athlete’s foot for years while the wife has never had it. Clearly the wife is exposed to the fungus, but her genetic makeup is such that she can fend off the disease.

What preventative measures can I take to decrease my chances of developing athlete’s foot?

Athlete’s foot prefers to grow in a dark environment; therefore, going barefoot or wearing sandals can be beneficial. Nothing cures athlete’s foot like a weekend at the beach with your feet in the salt water, sand, and sunshine.

Athlete’s foot also likes a moist environment; therefore, wearing absorbent socks to keep the moisture away from your skin is beneficial. Socks made from synthetic materials are better at “wicking” moisture away from the skin. Stay away from cotton socks. Cotton is good at absorbing moisture, but it holds the moisture against your skin creating an environment conducive to fungal growth.

One final, and perhaps less elegant home remedy is to urinate on your feet while in the shower. Yes, that’s right I said to pee on your feet. Urine contains a chemical called urea which is found in some antifungal medications. Urea is a strong keratolytic which means it dissolves skin. The urea assists in removing the scaly dry skin caused by the fungus. Urine is sterile and “all natural” so if you’re not too grossed out give it a whizz (ha!).

Are any of the over the counter (OTC) athlete’s foot medications any good?

Yes, most athlete’s foot can be cured with OTC medications. There are many available including: Desenex, Tineaside, and Lamisil cream. The creams are applied twice daily and the condition usually resolves in 2-3 weeks. We recommend continuing treatment for an additional week after the condition has resolved to prevent reoccurrence.

I’ve tried the home remedies and OTC medications, but I juts cant’ get rid of this fungus. Now what?

If you are particularly susceptible to athlete’s foot or have been infected by a resistant strain, topical OTC medications may not be enough to kill the infection. If this occurs, it is time to see a podiatrist. For very resistant strains of fungus or very susceptible individuals, oral antifungals are available. Oral antifungals are usually used in conjunction with prescription strength topical medications. Your podiatrist may also order blood work to rule out other underlying causes of the persistent infection.

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